How much rates vary
Facilitymedian $1,148 · 10th to 90th $269 to $1,950Professionalmedian $1,230 · 10th to 90th $347 to $3,020
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $1,174.90 | Facility | None | $269.15 | $1,148.15 | $1,174.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $870.96 | Facility | 54 · Surgery only | $199.53 | $213.80 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $1,000.00 Typical High $1,479.11 | Professional | None | $269.15 | $1,000.00 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $363.08 Typical High $933.25 | Professional | 54 · Surgery only | $199.53 | $363.08 | $933.25 |
BCBS North Dakota Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $2,630.27 | Professional | None | $489.78 | $741.31 | $2,630.27 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $588.84 Median $891.25 Typical High $3,162.28 | Professional | 22 · Increased work | $588.84 | $891.25 | $3,162.28 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $524.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $338.84 | $524.81 | $1,819.70 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $870.96 Typical High $2,570.40 | Professional | None | $331.13 | $870.96 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $794.33 Typical High $1,949.84 | Facility | None | $269.15 | $794.33 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $7,762.47 | Professional | None | $1,288.25 | $3,981.07 | $7,762.47 |
United Setting Professional Modifier None Typical Low $288.40 Median $1,047.13 Typical High $2,344.23 | Professional | None | $288.40 | $1,047.13 | $2,344.23 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $134.90 Median $141.25 Typical High $575.44 | Facility | 52 · Reduced service | $134.90 | $141.25 | $575.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $229.09 | Facility | 53 · Discontinued | $53.70 | $56.23 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $173.78 | Facility | 55 · Aftercare only | $39.81 | $42.66 | $173.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $114.82 | Facility | 56 · Pre-op care only | $26.92 | $28.18 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $239.88 Typical High $630.96 | Professional | 52 · Reduced service | $134.90 | $239.88 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $97.72 Typical High $251.19 | Professional | 53 · Discontinued | $53.70 | $97.72 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $72.44 Typical High $186.21 | Professional | 55 · Aftercare only | $39.81 | $72.44 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $48.98 Typical High $125.89 | Professional | 56 · Pre-op care only | $26.92 | $48.98 | $125.89 |
Where North Dakota sits
The same service costs 3.5 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 11th of 51
$1,175
WI $1,660MD $468
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.